From the Journals

Breast cancer care delayed when patients have high deductibles


Key clinical point: Many women have high-deductible health plans that may discourage them from seeking essential care when needed.

Major finding: Women with an employer-mandated switch from a low- to high-deductible health plan had significant delays in diagnostic imaging, biopsy, diagnosis, and cancer care.

Study details: Controlled pre-post study of data on 273,499 women and 2.4 million controls.

Disclosures: The study was supported by National Cancer Institute and National Institute of Health grants. Dr. Wharam and three coauthors reported no conflicts of interest. Three coauthors reported honoraria and/or consulting/advisory roles with various companies.

Source: Wharam et al. J Clin Oncol. 2018 Feb 28. doi: 10.1200/JCO.2017.75.2501.



High-deductible health insurance plans may be bad for women’s health, suggest results of a new study.

An analysis of data on women without evidence of breast cancer who were covered for at least 1 year in a low annual deductible plan and then switched by their employers to high annual deductible plans showed that when women were forced to shell out substantially more money before their insurance kicked in, they were significantly more likely to have delays in diagnostic breast imaging, breast biopsy, and initiation of chemotherapy.

“Such delays might lead to adverse long-term breast cancer outcomes. Policymakers, health insurers, and employers should consider designing or incentivizing health insurance benefits that facilitate transitions through key steps along the cancer care pathway,” wrote J. Frank Wharam, MB, and colleagues at Harvard Medical School and Harvard Pilgrim Health Care Institute in Boston. The report was published in Journal of Clinical Oncology.

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